The effect of Vacor diabetes mellitus on the quadriceps muscle capillary basement membrane thickness has been examined by the electron microscopic method. With this procedure, it was possible to obtain an objective evaluation of the significance of capillary basement membrane thickening in Vacor diabetes mellitus. The results of such a study on the muscle capillary basement membrane in 10 normal subjects and 9 Vacor-poisoned patients have demonstrated the following: (1) the average basement membrane width of Vacor patients (2801 A +/- SD 614) is over twice that of normal subjects (1300 +/- 185 A), and all 9 cases demonstrated muscle capillary basement membrane thickening; (2) there is a significant association of basement membrane width with age (P less than 0.01), but not with the duration of the disease or fasting blood glucose values in the Vacor group. The results of the present study indicate that diabetes mellitus induced by Vacor poisoning can lead to microangiopathy, and that such basement membrane thickening is an early and consistent finding.